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These 49 sufferers derived their supply from three shops only, and two of these
shops are supplied by one man from Billingsgate, thus practically confining the supply
to two sources.
Dr. Hamer pointed out that the amount of fried fish eaten in Southwark and
Bethnal Green is far larger than in any other part of London, and it has already been
shown that typhoid fever mainly occurs in a class of population among whom fried
fish eating is particularly common.
Analysis of the history with regard to fish eating, of the sufferers in the outbreak,
lead the Investigator to group the London cases, topographically, into 31 clusters or
groups.
These 31 clusters centre round 24 shops or stalls, and 7 market streets in which,
presumably, a single shop or stall was at fault, but a more precise indication of the
offending market is impossible. In addition to the 31 London groups, there are those
occurring outside the Metropolis, i.e., Tottenham and Edmonton, and further some
scattered groups of cases in Bermondsey, Lewisham, Battersea and Acton.
"It was clearly important to ascertain whether the 31 London retail supplies
"which thus fell under suspicion were in any way associated one with another.
"Were they in fact derived from common wholesale sources ? It was ascertained
"in every instance the retail supply was obtained direct from Billingsgate, and in
"all instances in which information with reference to this point could be obtained,
"the fish falling under suspicion was 'plaice' (including 'flounders' and
"'dabs'), and was, moreover, what is known as 'late steamer fish.' This exclusive
"derivation from Billingsgate is not, at first sight, remarkable, but having in view
"the fact that quite a considerable percentage of the small retail shops have fish
"sent direct from the coast by rail, it is a priori exceedingly unlikely that among
"31 retail vendors questioned, no single one would be so supplied. As regards
"the Billingsgate fish, roughly two-thirds is 'rail,' and one-third 'steamer fish,'
"and though the category 'late steamer fish' is one difficult to define precisely,
"it may certainly be assumed that considerably less than one-tenth of the fish
"sold at Billingsgate could be thus classified."
Dr. Hamer ascertained that in every instance where the retail supply fell under
suspicion they were derived direct from Billingsgate, and in all instances in which
information with reference to this point could be obtained, the fish falling under
suspicion was "plaice," including flounders and dabs, and was, moreover, known as
what is described as "late steamer fish."
In Tottenham and Edmonton, evidence pointed to particular fish shops having
been concerned in supplying the patients.
The circumstance of the outbreak of typhoid fever under investigation raises the
question with regard to London generally, and suggests that other widely scattered
and sporadic cases may also be due to fish inspection.
* The fish sold between, say 9 and 10 a.m., after the higher-priced fish has been disposed of, would appear to be
that referred to.